Organization
BON SECOURS DEPAUL MEDICAL CENTER
Active
Other names
Bon Secours Contemporary Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KERNER (CHEIF EXECUTIVE OFFICER)
(757) 673-5920
Entity
Organization
Contact information
Practice address
400 GRESHAM DR, SUITE 808, NORFOLK, VA 23507-1901
(757) 622-7998
(757) 215-2729
Mailing address
400 GRESHAM DR, SUITE 808, NORFOLK, VA 23507-1901
(757) 622-7998
(757) 215-2729
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06209
GROUP PTAN
VA
Enumeration date
10/16/2013
Last updated
10/16/2013
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